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肾内科第一章—急性肾损伤
Acute kidney injury(AKI)has emerged as a major public health problem that affects millions of patients worldwide and leads to decreased survival and increased progression of underlying chronic kidney disease(CKD).Recent consensus criteria for definition and classification of AKI have provided more consistent estimates of AKI epidemiology.Patients,in particular those in the ICU,are dying of AKI and not just simply with AKI.Even small changes in serum creatinine concentrations are associated with a substantial increase in the risk of death.
急性肾损伤(AKI)已成为一个重大的公共健康问题，它影响着全世界数百万患者，并导致了患者生存率的下降，加速了潜在慢性肾脏病(CKD)的进程。
AKI 最新公认的定义和分类标准为AKI的流行病学提供了更加一致的推论。
患者，特别是ICU里的患者，正在死于AKI，但不仅仅是AKI。
即使是血清肌酐浓度的微小变化也会导致死亡风险的显著增加。
知识点总结：
①survival n.生存率
②underlying adj.潜在的
③consensus n.共识
④classification n.分类
⑤epidemiology n.流行病学
⑥creatinine n.肌酐
⑦concentration n.浓度
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肾内科第二章—慢性肾脏病
Both hypertension(HTN)and Chronic Kidney Disease（CKD）are serious interrelated global public health problems.Nearly30%and15% of US adults have HTN and CKD,respectively.Because HTN may cause or result from CKD,HTN prevalence is higher and control more difficult with worse kidney function.Etiology of CKD,presence and degree of albuminuria,and genetic factors all influence HTN severity and prevalence.In addition,socioeconomic and lifestyle factors influence HTN prevalence and control.There are racial and ethnic disparities in the prevalence,treatment,risks,and outcomes of HTN in patients with CKD. Control of blood pressure(BP)in Hispanic and African Americans with CKD is worse than it is whites.
高血压(HTN)和慢性肾脏病（CKD）是相互关联的且严峻的全球公共健康问题。
近30%和15%的美国成年人分别患有高血压和慢性肾脏病。
由于HTN可导致CKD，也可由CKD导致，所以HTN患病率较高，且肾功能差的患者血压控制更困难。
慢性肾脏病的病因、蛋白尿的有无和程度以及遗传因素均影响HTN 的严重程度和患病率。
此外，社会经济和生活方式因素影响HTN的流行和控制。
CKD患者HTN的患病率、治疗方法、风险和预后存在种族和民族差异。
西语裔和非裔美国人慢性肾病脏患者的血压控制比白人差。
知识点总结：
①hypertension n.高血压
②respectively adv.各自的
③prevalence n.流行
④albuminuria n.白蛋白尿
⑤socioeconomic adj.社会经济的
⑥racial adj.种族的，人种的
⑦ethnic adj.民族的，种族的
⑧disparity n.差异
木仓医学考研复试
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肾内科第三章—肾病综合征
Nephrotic syndrome(NS)consists of peripheral edema,heavy proteinuria,and hypoalbuminemia,often with hyperlipidemia.Patients typically present with edema and fatigue,without evidence of heart failure or severe liver disease.The diagnosis of NS is based on typical clinical features with confirmation of heavy proteinuria and hypoalbuminemia.The patient history and selected diagnostic studies rule out important secondary causes,including diabetes mellitus,systemic lupus erythematosus,and medication adverse effects.Most cases of NS are considered idiopathic or primary;membranous nephropathy and focal segmental glomerulosclerosis are the most common histologic subtypes of primary NS in adults.
肾病综合征(NS)由外周水肿、大量蛋白尿和低蛋白血症组成，常伴有高脂血症。
患者通常表现为水肿和疲劳，无心力衰竭或严重肝病的迹象。
NS的诊断是基于严重的蛋白尿，低蛋白血症和典型的临床特征。
根据患者病史和所选的诊断检查可以排除重要的继发原因，包括糖尿病、系统性红斑狼疮和药物不良反应。
大多数NS病例被认为是特发性或原发性的；膜性肾病和局灶节段性肾小球硬化是成人原发性肾病最常见的组织学亚型。
知识点总结：
①rule out排除
②diabetes mellitus n.糖尿病
③systemic lupus erythematosus n.系统性红斑狼疮
④adverse effects n.副作用
⑤idiopathic adj.特发的
⑥focal segmental glomerulosclerosis n.局灶性节段性肾小球硬化
木仓医学考研复试
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肾内科第四章-血液透析
Venous air embolism(V AE)during hemodialysis（HD）is thought to be rare,but because signs and symptoms of air embolism may mimic other more common complications,careful vigilance and high suspicion are required for the diagnosis.Air bubbles trapped in the systemic (pulmonary or cerebral)microcirculation may cause local ischemia, circulatory arrest,activation of complement and coagulation system, localized inflammation,and vascular endothelial cell damage.
尽管在血液透析（HD）期间发生静脉空气栓塞很罕见，但是在诊断空气栓塞的时候仍要保持小心警惕和高度怀疑，因为它的表现和症状与其他更常见的并发症很相似。
堵塞于系统微循环（肺循环或者脑循环）中的气泡可能会导致局部缺血、循环骤停、补体和凝血系统的激活、局部炎症和血管内皮细胞的损伤。
知识点总结：
①venous adj.静脉的
②embolism adj.间质的
③hemodialysis n.血液透析
④mimic n.实质，本质
⑤vigilance n.肾脏的
⑥bubble n.活检
⑦ischemia n.结节病
⑧complement n.结核病
⑨vascular adj.真菌的
⑩endothelial n.多血管炎
⑪tubular n.管状的
⑫atrophy n.萎缩。